A alimentação da criança no primeiro ano de vida é essencial para o crescimento e desenvolvimento adequados. A Organização Mundial de Saúde (OMS) recomenda que o aleitamento materno seja exclusivo até os seis meses de vida e que os alimentos complementares sejam introduzidos a partir desta idade. Os objetivos desta pesquisa foram estimar a prevalência do aleitamento materno em crianças menores de 1 ano de idade e descrever a alimentação complementar entre as crianças estudadas. O estudo transversal, descritivo abrangeu 821 crianças menores de um ano de idade vacinadas na Segunda Etapa da Campanha Nacional de Vacinação nos Postos de Saúde da cidade de Guarapuava-PR. A coleta dos dados foi realizada com as mães e/ou responsáveis por crianças menores de 1 ano de idade que compareceram aos Postos de Saúde naquela data. O instrumento utilizado nesta pesquisa foi o questionário elaborado e validado pelo Instituto de Saúde da Secretaria Estadual de Saúde de São Paulo-SP e parcerias. A análise dos dados deu-se através da análise das freqüências simples de todas as variáveis coletadas. Com relação aos indicadores de aleitamento materno, 68,9% das crianças estavam em aleitamento materno, sendo 86,2% e 39,8% entre crianças menores de 4 e 6 meses, respectivamente. Considerando os indicadores de aleitamento materno exclusivo e predominante, verificou-se que entre as crianças menores de 4 meses foi de 46,4% e 41,4%, respectivamente. Para as crianças menores de 6 meses, verificou-se os seguintes percentuais: 37,3% e 18,9%, respectivamente. Entre as crianças menores de quatro e seis meses, 31,9% e 45,3% estavam recebendo outro tipo de leite que não o humano. Entre as crianças menores ou iguais a 4 meses, 5,1% estavam em alimentação complementar, e entre as menores ou iguais a 6 meses 14% , recebendo chá, água, suco, fruta, sopa de legumes e comida de panela nas últimas 24 horas. Este estudo mostrou que os indicadores de Aleitamento Materno – Aleitamento Materno e Aleitamento Materno Exclusivo estão muito aquém do preconizado pela OMS e que a introdução da alimentação complementar é precoce tanto entre crianças amamentadas como em crianças não amamentadas. / What children eat in the first year of life is essential with a view to adequate growth and development. The World Health Organization (WHO) recommends exclusive breastfeeding up to six months of age and that complementary foods be introduced from that age onwards. This study aimed to examine the prevalence of breastfeeding among children under 1 year old, as well as to describe the introduction of complementary foods among the children in this study. A cross-sectional and descriptive study was realized among 821 infants under 1 year old who were vaccinated in the Second Phase of the National Vaccination Campaign at Health Centers in Guarapuava-PR, Brazil. Data collection involved the mothers and/or responsibles for infants under 1 year old who came to the Health Centers on that day, using the questionnaire elaborated and validated by the Health Institute of the São Paulo State Health Secretary and its partners. The collected data were subject to simple frequency analysis of all variables. As to breastfeeding indicators, 68.9% of the infants received breastfeeding, with 86.2% and 39.8% of children under 4 and 6 months, respectively. Exclusive and predominant breastfeeding indicators corresponded to 46.4% and 41.4%, respectively, among children under 4 months old, against 37.3% and 18.9% for children under 6 months of age. 31.9% and 45.3% of children under 4 and 6 months old were receiving nonhuman milk. 5.1% of children aged 4 months or older and 14% of those aged 6 months or older received complementary feeding, having consumed tea, water, juice, fruit, vegetable soup and homemade food during the last 24 hours. This study has shown that Breastfeeding – Breastfeeding and Exclusive Breastfeeding indicators remain much below the levels set by the WHO and that complementary foods are introduced at an early stage for children who are breastfed or not.

O presente trabalho propõe-se analisar a forma como os fatores sociais, associados à prática do aleitamento materno, vêm sendo tratados na literatura científica. Num primeiro momento, procura identificar o comportamento do volume da produção científica, seguindo-se à identificação e análise dos fatores sociais arrolados nos estudos sobre a prática do aleitamento materno. O material de estudo compreende os trabalhos indexados na \"Nutrition Abstracts and Reviews\", no período de 1945 a 1985. Concluiu-se que a produção de conhecimento científico sobre o aleitamento materno faz-se presente em todo o desenvolvimento científico sobre nutrição infantil, no período estudado, com importância relativa acentuada em determinados momentos históricos. Destaca-se a produção de trabalhos sobre a prática do aleitamento materno dentre os estudos sobre o aleitamento materno. Identificam-se, como mais freqÜentes, entre os fatores sociais associados, o nível socio-econômico, o nível educacional, a distribuição urbano-rural e o trabalho da mulher. Os fatores sociais, arrolados nos estudos sobre a prática do aleitamento materno, caracterizam-se numa abordagem predominantemente multicausal. / The purpose of this work is to analyse how social factors associated with breast-feeding have dealt with scientifical literature. At first it outlines the behavior of the total scientific production and then it identifies and analyses the social factors connected up with the practice of breast-feeding. The material for this study encloses all the papers indexed in Nutrition Abstracts and Reviews throughout the period comprised between 1945 and 1985. There is concluded that the production of scientific knowledge on breast-feeding has been present throughout the general scientific development of child nutrition in the studied period with relative more deeper importance at certain historical moments. The practive of breast-feeding has been more dealt with studying breast-feeding at large. The most frequently associated social factors that were identified in this work were the socio-economic level, the educational level, the urban-rural distribution and women employment. These social factors connected up with breast-feeding practice have been approached essentialy from a multicausal angle.

Estudou-se a prática do aleitamento materno nas mulheres com filhos menores de três anos de idade, na população de Icapara, Município de Iguape, Estado de São Paulo. Procurou-se determinar, entre as famílias selecionadas, a frequência e duração dos tipos de aleitamento do último filho, no primeiro ano de vida. Em seguida, fez-se um estudo comparativo do aleitamento do primeiro e último filhos nas mesmas famílias. Com a finalidade de situar a prática do aleitamento materno num contexto social, caracterizou-se sócio-economicamente a população estudada, privilegiando-se as atividades ocupacionais. A técnica de pesquisa empregada foi o formulário aplicado aos pais. Concluiu-se que no primeiro ano de vida, o aleitamento materno total é frequente e prolongado, enquanto que o aleitamento materno exclusivo é frequente apenas em torno do período neo-natal. O aleitamento artificial apresenta-se com frequências ascendentes, atingindo-se mais da metade das crianças ao final do período. O aleitamento misto aparece com frequências variáveis, cedendo lugar ao aleitamento materno exclusivo em torno do período neo-natal e ao aleitamento artificial na forma exclusiva, no primeiro ano de vida. Verificou-se que as frequências de aleitamento materno são, em geral, mais baixas nos último filho do que nos primogênitos. / The breast-feeding practice among women with children under 3 years of age in the population of Vila de Icapara, Iguape County, State of São Paulo, was studied. The author tried to determine the rate of occurrence and duration of different types of feeding offered to the last child of the selected families, in his first year of life. A comparative study between the feeding of the first and the last child in the same family was also carried out. In order to situate the breast-feeding practice within a social context, the chosen population was social and economically studied taking into consideration especially occupational activities. A questionnaire was applied as the researdh technique. The author concluded that, total breast-feeding is frequent and prolonged in the child\'s first year of life, while the exclusive breast-feeding is frequent only during the neo-natal period. The bottle-feeding presents a increasing occurence totalizing more than half of the children up to 1 (one) year of age. The mixed feeding varies giving ground to the exclusive breast-feeding during the neo-natal period, and to bottle-feeding (exclusively) during the child\'s first year of life.

Introducción: La desnutrición crónica repercute en el crecimiento y desarrollo del niño menor de 5 años. Investigaciones afirman que la lactancia materna exclusiva junto con otras estrategias, como un intervalo de nacimiento mayor a 24 meses, favorecen al adecuado crecimiento del niño. Nuestro objetivo fue determinar la asociación entre el intervalo de nacimiento y el z-score de talla / edad en niños menores de 5 años, en presencia o ausencia de lactancia materna exclusiva. Materiales y métodos: Se utilizó la base de datos de la ENDES 2017. Para la asociación se trabajó con el intervalo de nacimiento y el z-score de la talla / edad, de niños menores de 5 años y se empleó la variable de estratificación lactancia materna exclusiva. Se aplicó un modelo de regresión lineal para estimar la asociación del z-score de la talla / edad e intervalo de nacimiento según presencia o ausencia de lactancia materna exclusiva. Resultados: Los resultados de la presente investigación sugieren que existe asociación entre el intervalo de nacimiento y el z-score de la talla / edad. Los niños con intervalo de nacimiento menor o igual a 24 meses tienen menor z-score de talla / edad en comparación a los niños con un intervalo de nacimiento mayor a 24 meses. Conclusión: Los niños con intervalo de nacimiento menor o igual a 24 meses se asociaron con un menor z-score de talla / edad independientemente si han lactado o no de forma exclusiva. / Background: Chronic malnutrition has an impact on the growth and development of children under 5 years of age. Research states that exclusive breastfeeding along with other strategies, such as a birth interval greater than 24 months, favor the development and proper growth of the child. Our objective was to determine the association between the birth interval and the z-score of height for age in children under 5 years of age, in the presence or absence of exclusive breastfeeding Methods: The database of the ENDES 2017 was used. For the association we worked with the birth interval and the z-score of the height for the age of each child under 5 years old and the stratification variable exclusive breastfeeding was used. A linear regression model was applied to estimate the association of height z-score for age and birth interval according to the presence or absence of exclusive breastfeeding. Results: The results of the present investigation suggest that there is an association between the birth interval and the z-score of the height for the age. Children with a birth interval of less than 24 months have a lower z-score of height for age compared to children with a birth interval greater than 24 months. / Tesis

No description available.

No description available.

No description available.

Case Report: The Tennessee Initiative for Perinatal Quality Care (TIPQC) is a statewide quality improvement collaborative founded in 2009. Members elected to develop a project to address Tennessee’s low breastfeeding rates. The project aim is to improve the health of infants and mothers in Tennessee by increasing initiation and duration of breastfeeding through systematically promoting breastfeeding at prenatal care visits. The short-term project goal is to increase the fraction of infants who are fed breastfmilk at the maternal post-partum visit by 50% by March 2012. A toolkit of evidence-based practices was developed by an interdisciplinary project development team through a combination of face-to-face meetings and webinars. Published tools from the AAP, ACOG, ABM, and elsewhere were reviewed to complete this toolkit. Inclusion of a practice in the toolkit was based on evidence of effectiveness and consensus/approval by the project development team and pilot centers. Toolkit format and project protocols were designed to be consistent with other TIPQC projects. The target population for this project includes expectant mothers presenting for routine prenatal care in the outpatient clinic. Project outcomes will be measured at the first postpartum visit at 4-8 weeks post-delivery. The project pilot was launched in three TN practices in spring 2011. Participating practices will first establish a primary improvement team that includes relevant stakeholders and a project champion and team leader. Ongoing project support will be provided through regional learning session and webinars. In recognition of the range of needs and varied resources across the state, the toolkit includes a menu of “potentially better practices” (PBPs) that may be implemented individually, or as a bundle. Success of this project relies on high reliability (>90%) implementation of processes that promote breastfeeding in the prenatal clinic and the use of rapid Plan-Do-Study-Act (PDSA) cycles. Use of a web-based data-entry system through REDCap will allow practices to access on-demand run-charts and control charts for their project data as well as automated comparisons to project-wide aggregate data. The fractions of mothers’ exclusively feeding breastmilk, feeding both breastmilk and formula, and feeding exclusively formula at the first post-partum visit at 4-8 weeks post-delivery will be determined. The fraction of mothers with infants readmitted to the hospital after birth will be tracked as a balancing measure. Local audits will be used to evaluate reliability of implementation of potentially better practices. Discussion: This project may serve as a model for how quality improvement methodologies may be combined with use of distance-learning and web-based data entry and reporting to facilitate dissemination and measured implementation of potentially better practices across a broad geographic region with highly diverse populations. The approach has the potential to increase breastfeeding rates and improve health and could be modified for application in delivery and postnatal settings.

Case Report: Through the Tennessee Initiative for Perinatal Quality Care (www.tipqc.org), four pilot prenatal (Family Medicine and OB-GYN) practices representing academic and private groups from across the state established primary improvement teams including relevant stakeholders. An online toolkit of evidence-based practices and published tools from the AAP, ACOG, ABM, and elsewhere was developed by an interdisciplinary team and provided to pilot practices. The toolkit included a menu of “potentially better practices” (PBPs) that could be implemented individually, or as a bundle. Success of this project relied on use of rapid Plan-Do-Study-Act (PDSA) cycles. Pilot practices were educated on basic QI procedures, data collection, toolkit content, etc. and shared experiences through monthly webinars called “Huddles”. Regional trainings were also provided at various intervals by the TIPQC staff. Before implementation of a PBP, each practice collected their baseline breastfeeding rate at the 4-8 week postpartum visit. Practices used a web-based, HIPAA-compliant data-entry system through REDCap. The project was reviewed and approved by the Institutional Review Boards (IRBs) of participating pilots, and funded under an agreement with the state of Tennessee. PBPs implemented by the pilot practices included: - Providing resident and provider education - Distributing written literature on breastfeeding benefits and advice - Providing written breastfeeding prescriptions - Having patients view educational breastfeeding videos - Creating a breastfeeding-friendly office environment Baseline pilot data revealed that at presentation for the first postpartum visit, 28.1%, 23%, and 49% of mothers were exclusively feeding breastmilk, feeding a mix of breastmilk and formula, and exclusively feeding formula, respectively (n=196). Baseline data was successfully collected, and early data following the first PDSA has been collected across the four pilot participants. For participating practices, this is the first time they have systematically looked at their 6-week breastfeeding rates. Open communication and brainstorming across the various practices has been very helpful. A numbers of challenges have been cited, including time constraints related to large volumes of patients and inability to extract data electronically, coordination of efforts among large numbers of providers and staff who may be unfamiliar with breastfeeding, and a need for more family, hospital, and community provider support for breastfeeding. Discussion: This quality improvement prenatal breastfeeding promotion pilot project provides insight into the process of team building and use of thin data sets to drive practice level improvement, and lays the groundwork for statewide spread, where challenges encountered in the pilot centers can be addressed. Participants are now looking at the reliability of their implementation, and determining whether their initial selections from the menu/toolkit were effective.

No description available.